RT Journal Article
SR Electronic
T1 Impact of norepinephrine versus phenylephrine on brain circulation, organ blood flow and tissue oxygenation in anaesthetised patients with brain tumours: study protocol for a randomised controlled trial
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e095172
DO 10.1136/bmjopen-2024-095172
VO 15
IS 3
A1 Faisal Mohamad, Niwar
A1 Koch, Klaus Ulrik
A1 Aanerud, Joel
A1 Meier, Kaare
A1 Mikkelsen, Irene Klærke
A1 Espelund, Ulrick S
A1 Eriksen, Christian Fenger
A1 Juul, Niels
A1 Alstrup, Karen Baden
A1 Jespersen, Bo
A1 Fries, Lene Marie
A1 Tankisi, Alp
A1 Dyrskog, Stig
A1 Cortnum, Søren Ole Stigaard
A1 Sindby, Ann Katrine
A1 Borghammer, Per
A1 Tolbod, Lars Poulsen
A1 Meng, LingZhong
A1 Korshoej, Anders Rosendal
A1 Rasmussen, Mads
YR 2025
UL http://bmjopen.bmj.com/content/15/3/e095172.abstract
AB Introduction Vasopressor support is often preferred as an efficient and convenient way to raise the blood pressure during surgery and intensive care therapy. However, the optimal vasopressor for ensuring organ blood flow and tissue oxygen delivery during surgery remains undetermined. This study aims to assess the impact of norepinephrine versus phenylephrine on cerebral and non-cerebral organ perfusion and oxygenation during anaesthesia in neurosurgical patients with brain tumours. The study also explores the impact of the vasopressor agents on the distribution of cardiac output between various organs.Methods and analysis This is an investigator-initiated, double-blinded, randomised clinical trial including 32 patients scheduled for supratentorial brain tumour surgery. The patients are randomised to receive a phenylephrine or norepinephrine infusion during preoperative positron emission tomography (PET) examinations and the following neurosurgical procedure. PET measurements of blood flow and oxygen metabolism in the brain and other organs are performed on the awake subject during anaesthesia, following a 10% and 20% gradual increase in blood pressure from the baseline value. The primary endpoint is the between-group difference in cerebral blood flow. Secondary endpoints include detection of ischaemic brain lesions possibly associated with vasopressor treatment, changes in cerebral oxygen metabolism, non-cerebral organ blood flow and oxygen metabolism, cardiac output, regional cerebral oxygen saturation, autoregulation and distribution of cardiac output between organs.Ethics and dissemination This study was approved by the Danish National Medical Ethics Committee (20 May 2022; 2203674). Results will be disseminated via peer-reviewed publication and presentation at international conferences.Trial registration number EudraCT no: 2021-006168-26. ClinicalTrials.gov: NCT06083948.